Breast Implant Drop & Breast Implant “Fluff”.

It is good to be aware of Breast Implant expectations prior to deciding on breast augmentation surgery. All surgeries involve postoperative swelling (edema) and a period of healing that can take several months to a year to fully settle down. Scar tissue involving deep soft tissue, muscle and superficial skin, can feel firm and hard initially. Healing starts with immature collagen (Type III) which is unorganized and has less tensile strength. As your body heals, injured tissues secrete small hormones called cytokines that signal capillaries to grow into the wound (a process called neovascularization). Blood supply grows into these tissues in order to help heal and bring in fibroblast “fixer” cells. A robust blood supply also brings in much-needed oxygen and nutrients. (This process is more difficult for smokers, poorly controlled diabetics, people with poor nutrition, and other less healthy individuals).

Vascular ingrowth can contribute to swelling, inflammation and redness after surgery - which is often obvious with many skin scars remaining pink for several months after surgery.

Immediately following surgery: the soft tissue, muscle and skin surrounding the implant experience significant swelling.

Swollen muscle and soft tissue can temporarily push the breast implants upwards. This can often create an engorged breast with a high breast implant position.

In most healthy patients, the wounds heal with a conversion of immature Type III collagen into a more organized stronger Type I (or mature) collagen. With time, the healing tissues become stronger, with a more mature collagen ratio. This typically allows the healing tissues to acquire a much softer and more natural feel.

Every patient is different. Every patient has different skin elasticity, healing times, and how their tissues respond to the forces of gravity. Some of this is genetic. Other variables or changes can be acquired after environmental influences such as history of breast feeding.

This process varies in timing for everyone, but is very common among breast implant patients. It can take many months for some patient’s breast tissue to soften, as post-inflammation diminishes. When the edema subsides, the muscle, breast tissue and skin softens and the breast implants fall into fill the lower portion of the breast pocket.

Breast Implant Settling: This process is often also referred to as “Breast Implant Fluffing” or the time it takes your “Breast Implants to Drop”.

As the surgical sites heal, the healed tissue no longer requires such a profuse blood supply. With time, the hormones (cytokines) secreted - initially to recruit the blood supply - are no longer needed. In most healthy patients, at this time, the blood vessels shrink, swelling subsides, and the scars fade from pink to lighter in color. This process can take up to, and even over a year to fully settle. Usually 70-80% of wound healing, scar maturation, and swelling subsides between 3-8 months. Every patient is different. Typically, the scars fade with time even after a year.

Most patients scar well, but some are more problematic scar formers. If scars continue to be red, raised or problematic after 1-3 months – nonsurgical scar revision such as laser or steroid injection may be considered by your surgeon. Surgical scar revision is typically delayed for 8-12 months to allow the maturation process to declare itself.

Managing the Breast Implant Settling or “Fluffing” Process

As each patient is unique, so are each of their breasts! Just as each patient’s surgical plan is custom tailored, so is their post operative breast implant and incisional scar treatment plan. Dr. Lampert believes in frequent early follow up to evaluate and help best control the healing process. Massage protocols, surgical bras, medications, and sometimes bra strap garments are utilized depending on the specific patient’s needs.